=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649044967
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VIOLANTI MENTAL HEALTH COUNSELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2023
-----------------------------------------------------
Last Update Date | 11/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4535 SOUTHWESTERN BLVD STE 710B
-----------------------------------------------------
City | HAMBURG
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14075-1870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-431-3314
-----------------------------------------------------
Fax | 716-431-3310
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4535 SOUTHWESTERN BLVD STE 710B
-----------------------------------------------------
City | HAMBURG
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14075-1870
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-431-3314
-----------------------------------------------------
Fax | 716-431-3310
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/LMHC
-----------------------------------------------------
Name | CAITLIN VIOLANTI
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 716-431-3314
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------